Thursday, August 18, 2016

Real talk. I've been living with a variety of stomach/digestive issues since I was in high school, discovered by my not-so-crack pediatrician after a bout of reflux nearly sent me to the ER after having a late night, very-fancy-for-a-16 year old cappuccino at a local cafe with a friend of mine. This was the same crack pediatrician who used to give me antibiotics like they were candy to treat strep throat and - what I've since come to learn is totally made up - a "carrier case" of strep. By the time the coffee drink nearly killed me, I was well on my way to killing off all the good bacteria in my body and setting myself up for what would turn out to be MANY years of pain, doctor's visits, nasty tests.

Am I entirely blaming poor Dr. Kaufman who also thought the best way to treat a cyst on my hand (when I was 8) was by slamming it with a hard copy of Grey's Anatomy? Well, maybe a little. But the antibiotic overload continued with many other doctors for lots of other conditions over many more years. And then there was the matter of my seemingly innate tendency to worry about everything.

In the past few years, the digestive challenges became exponentially worse (as I've documented here as well). I had stomach bleeding, muscle wasting, pain, difficulty swallowing, terrible reflux/heartburn. Many endoscopies and colonoscopies and biopsies and medications later, I also had few answers as to why things were so bad, but because of my other underlying medical conditions I continued to be monitored and tested (see: "watchful waiting") meanwhile struggling to enjoy foods that I don't just love but adore.

Finally, my doctor here in Portland decided to test me for something called SIBO - small intestine bacterial overgrowth. A relatively newly discovered issue that involves bacteria from the large intestine migrating to the - supposed to be sterile - small intestine causing issues such as pain, heartburn, gas, severe bloating, constipation, diarrhea, etc. Everything that has historically been labelled "Irritable Bowel Syndrome" may in fact be SIBO.

The test is really, really, truly, really no fun. For four days, you discontinue medications that you may have been depending on to get through the day (i.e. antacids and/or non-stimulant, osmotic laxatives such as Miralax) and on the fourth day eat only completely plain protein for 24 hours. In my case that meant scrambled eggs and broiled salmon. By the end of the day, your body thinks you're trying to kill yourself and you're nauseous and headache-y. And then the next morning you drink a cup of lactulose (a sugar alcohol that can act as a laxative) and for the next three hours, you take breath samples every 20 minutes to determine if you are essentially off-gassing hydrogen and methane. Two gases that shouldn't be, um, coming up. The only people for whom this will show positive results have SIBO. By the end of taking my samples, I considered blowing my head off out of pure physical discomfort. Headache, nausea, bloating, dizziness. Oh and then I had to go to work. Good times.

Ok. So if you're still with me, surprise surprise I found out that I have SIBO and here's where things got even more challenging. My doctor explained that SIBO is exceedingly hard to treat. Many people go on a specialized liquid diet for a month and take powerful antibiotics that I learned (when my insurance refused to cover the cost) total up to almost $2000. The other alternative is a VERY restricted diet and herbal antibiotics that, studies have shown, are equally effective as the pharmaceutical but take longer to work. I had no other choice and this would be my route for at least two months, longer if the protocol didn't work, and even longer if I cheated.

Here's what I learned I could not eat: Sugar of any kind, artificial sweetener, nuts and seeds, grains of any kind, alcohol, soy, dairy (except aged cheese and homemade yogurt if I didn't already have a dairy allergy so...no go there). I could eat plain protein: eggs, chicken, turkey, beef, game, fish, shellfish. I could eat a few vegetables (zucchini, leafy greens, tomatoes, carrots, radishes, peppers, ginger) and berries (approximately 1/2 cup per day). Spices are also ok. Meals needed to be spaced out by 4 hours and antibiotic needed to be taken in between. Because I am a chocolate fiend who depends on it for mood boosting and magnesium, I was able to include 3 tablespoons of plain cocoa/cacao a day OR 1 oz of unsweetened 100% baker's chocolate. This would have to carry me through!

I am currently on Day 40 and here's what I've learned so far:
1. I love food even more than I thought I did. I want to marry food. Especially the food I can't eat.
2. Olive oil can be and should be poured on everything in copious amounts.
3. Food restriction is not my bag
4. Beer = summer. When there is no beer (or ice cream!!), does summer really exist?
5. Having visions brought on by a little hint of starvation should be expected
6. When and if you cheat (as I did with a piece of my own cake and some lactose free ice cream) YOU HAVE TO START ALL OVER AGAIN

Insert sobbing here.

So...This is the situation. I'm trying to make the best of it. I am less fun at dinner gatherings because, for the most part, I'm bringing my own food with me everywhere I go. BUT on an up note, I think I have figured out a way to make eating the most extraordinarily pleasurable, healthy, nourishing experience I never thought possible. I feel more connected to what I'm eating and am mindful of appreciating every bite. Living in the Pacific Northwest has also given me access to incredibly fresh and affordable seafood, meats, and vegetables. Canned shellfish is a really affordable and easily transportable way to get great protein (and iron) when you're not going to be at home.

I've included recipes for two of my faves above and I'll keep on documenting and posting this journey which I anticipate will be lengthy in the hopes of feeling better and spreading the SIBO diet food lurve.
For more info on SIBO: http://www.siboinfo.com/overview.html
For more info on SIBO testing: http://sibocenter.com/are-you-a-patient/Kale "pancake" & heirloom tomato salad
1/2 cup of cooked organic kale (I use frozen kale cooked in the microwave for ease and cheapness)
1 egg
1/2 cup - 1 cup baby tomatoes
Lots of olive oil!

Oil up your frying pan and place it on the heat while you prep everything else.

Beat an egg in a mixing bowl with a fork. Stir in cooked kale. Allow the kale to absorb the egg a bit. Pour on to the griddle in a pancake shape. Cook for 2 minutes on each side until cooked through. Serve with chopped tomatoes, extra greens, and lots of olive oil and sea salt poured on top.

Zucchini noodles & kale basil pesto with clams
*If you don't have a spiralizer, use a veggie peeler to make the noodles.

Sunday, May 8, 2016

I love dessert and I am a huge fan of nuts, but following a low glycemic, paleo-ish diet has meant eating more nuts and nut flours in a few short months than I have in an entire lifetime. I'm so sick of the taste of almond flour I almost cry when I look at it sitting there in the fridge, laughing at me, daring me to replace it with the refined pastry flour of yore.

Hence, this brownie. It's damn tasty. It doesn't have any nut flour. It does have, sigh, a little bit of coconut flour but you almost can't tell. These are best when allowed to cool and then refrigerate for a bit where they take on a kind of deep chocolate fudge quality. Straight out of the oven they are almost like a baked pudding which ain't bad either. Have I mentioned they don't have any nuts? Can I get an amen?

With an electric mixer, beat the three eggs until frothy. Add sweetener of choice, vanilla extract, tahini, and then slightly cooled oil or ghee. Add cocoa and coconut flour until combined. Stir in chocolate chips or chopped chocolate bar.

Monday, April 11, 2016

Recently, I was on an airplane that took off in high winds, headed for 40,000 feet, with a planned flying time of approximately 6 hours in duration.

These are facts. Shared with all of us passengers on the plane by the pilot via intercom. This is the weather. This is the height we plan to fly. This is how long we will be flying. No biggie, his voice seemed to convey. Just sit back, relax, etc., etc.

Notice these facts. Devoid of any emotion besides those which you - the reader - imposed based on your own experience of flying. Editor's note: Did I mention I was flying in coach? That's a fact too. Do with it what you will.

Now, here's how I felt about the facts:
Recently, I was on an airplane that took off in high winds (JESUS F*ING CHRIST!!), headed for 40,000 feet (IS THIS A ROLLER COASTER??? WE ARE ALL GOING TO DIE!!), with a planned flying time of approximately 6 hours in duration (WHAT FLYING TIME??!! WE ARE GOING DOWN BEFORE WE EVEN GET UP!!!AND IF BY SOME MIRACLE WE GET UP TO 40,000 FEET WE'VE GOT 6 HOURS TO RIDE THIS ROLLER COASTER OF DEATH!!!!).

Ok, those are my thoughts, my interpretation about the facts. My feeling was quite simply, terror. Beyond fear, I was terrified.

If we connect my feeling of terror to my thoughts it would look like this:I feel terrified because I am sitting in a tiny seat, in a plane I have no control over, in very uncomfortable, turbulent weather that makes me feel dizzy and disoriented and nauseous. I feel terrified that these very uncomfortable conditions will continue for 6 hours and that I will be violently ill and that the plane and the pilot will encounter unexpected issues that will lead to our untimely death. I feel terrified that I am going to die a scary horrible death in this plane today.

My thoughts are my interpretation of the facts. Everyone will have a different interpretation of the facts based on their own experience.

FYI: Feelings are experienced in the body. Thoughts occur in the mind. I feel terrified. I think I am going to die. The facts are that I am in an airplane, in high winds, traveling to 40,000 feet, and the time it will take to arrive at our destination is approximately 6 hours.

When individual interpretation and feeling is removed (without getting too philosophical about it and debating over whether time and distance and high winds are, in fact, "fact"), the facts remain. They are what they are. The facts are the cheese. The cheese stands alone. Something like that.

Why does any of this matter?

Because we impose interpretation (thoughts) on everything and those interpretations (thoughts) impact how we feel. How we feel impacts how we act which impacts our progress in life, our self-esteem, relationships, and the list goes on.

Going back to my airplane story, I felt terrified and so I immediately did what I always do when I feel scared: I looked for any way that I could control the situation. I turned towards the window and I stared out at the clouds, the ground, the wing of the plane. I looked at the seatbelt sign (still lit). I checked my seatbelt. I turned off my music to make sure I could hear any announcements from the pilot. I crossed and uncrossed my fingers. I prayed.

While I was busy trying to find a way to control the situation I found myself in, my body automatically did what bodies do when they sense threat: My heart-rate sped up, I started to breathe heavily, my face flushed (blood pressure increased), I stared to feel clammy and sweaty, I felt a strong knot in my stomach as my digestion slowed down and prepared me to try to escape. This automatic reaction is the "fight / flight / freeze" response that all humans have in response to threat. These bodily functions happen without us thinking about it. They are part of the autonomic nervous system and take care of all of the things that keep us alive: breathing, heart rate, digestion, etc. Fight / flight / freeze have kept us alive for millions of years, running from tigers, protecting ourselves from aggressors, standing still until a threat passes.

But fight / flight / freeze also takes a toll on the body if sustained. Elevated heart rate and blood pressure, slowed digestion, increase in hormonal activity (cortisol and adrenaline) are not supposed to be activated for long. Nature intended for these systems to kick in temporarily to help us get away from a threat, not to hang out for hours and hours (and days and weeks) in the threat. In other words, the tiger is coming, run away from / kill / hide from the tiger and then get on with your life.

But what if the flight is 6 hours long and it's going to be a really bumpy ride? Or if you have a medical diagnosis that must be followed every 1-6 months to assess progression? What then?

I'll write more about this in future postings, but here's what I did during this particular flight. It almost felt like magic.

I didn't "do" anything.

What??!!, you might ask. How the hell is that magic??

Here's the thing. As I wrote at the beginning, facts are pretty much facts. Again, many philosophers I know (and you know who you are) might (would definitely) argue this with me. But in general, things like time, distance, speed, height, weather conditions are what they are in the moment. The same thing with blood test results. Yes you could argue that the instruments used to measure any of these things might be faulty and, yes, many instruments show different values. But assuming that all of the tools used to measure are well-calibrated, the measurements are what they are (i.e. You can blame your ten pound weight gain on the scale, but that's just because you don't like what it says. Interpretation. Nuff said.).

At the end of the day, our problem comes from our interpretation of and feelings related to the facts. My flight was shaping up to be a long, very bumpy one. I do not like the feeling of turbulence, I do experience motion sickness, and I don't like sitting for 6 hours feeling uncomfortable. My feelings impacted my interpretation of the facts: that this particular flight in these conditions would lead to unpleasantness and death.

So in this case, I suddenly realized that all of my staring out the window and nervous twitches and tics and white-knuckling didn't have ANY impact on the facts at all. Nothing that I was doing to mitigate my feeling of anxiety while strapped into my chair in row 29 was going to change the weather or the plane or the pilot. NONE OF IT. In other words, all of my worrying was entirely useless. It was only making me feel sick. My high blood pressure wasn't going to smooth out the turbulence.

I decided to do the opposite of everything I wanted to do which was to run screaming down the aisle (or really, to get off the plane). I sat facing forward in my seat. I folded my hands over my belly. I closed my eyes. And I counted slowly backwards from 100, telling myself that I could not open my eyes until I reached 1. Why? Because whether or not my eyes were closed was not going to change the turbulence or the pilot. I made a decision to sit with my uncomfortable feeling. This is the very essence of mindfulness. Did it feel shitty? You bet. But I am strong. I can tolerate shitty feeling. It's not going to kill me. Fear, on the other hand. Fear will kill you. High blood pressure will kill you. Sitting with my eyes closed, hands gently folded, facing forward, I allowed myself to just be in the discomfort knowing that this feeling would pass. Believe it or not, all feelings ebb and flow. Give a crappy feeling 10 - 15 minutes and it will be at least a little better than it was. I sat and I counted and I rode the waves. I didn't try to interpret what I was feeling, I just counted and rode. You'll never believe what happened next.

Tuesday, March 22, 2016

The idea for this banana bread stemmed from my deep love of all things Saturday morning breakfast treat. No better way to combat the chilly rain of Portland than with a good strong cup of black coffee and something chocolate baking in the oven. Diet changes/restrictions mean that the sweeter and grainier baked goods of yore are, well, of yore nowadays. THIS is what I call paleo baking: a moist cake, no refined sugar and not too sweet, protein based (eggs), studded with dark chocolate (or cacao nibs), perfumed with banana and vanilla. It is so good. And I am so sad that the entire thing has been eaten. Then again, there's always this weekend.

Combine mashed bananas, eggs, melted coconut oil, vanilla, and tahini. Mix well using a spoon or an electric beater.
In a separate bowl, mix coconut flour, baking soda, and baking powder.
Add flour combination to banana combo in 3 parts to insure it is well combined. Then stir in chocolate chips/cacao nibs.
Pour into greased loaf pan and bake for 45 minutes. Done when tester comes out clean.
Allow to cool in the pan for at least 20 minutes before putting on rack to continue cooling.

Saturday, March 5, 2016

Scones, particularly chocolate chip scones, are one of my all time favorite foods on earth. But since they aren't exactly a health food and are generally considered to be about the farthest thing from diabetic or paleo friendly, I decided that I had to take matters into my own hands because, well, life's too short. During the week, I completely avoid all added sugar which has definitely made a difference in how I feel (and my blood glucose numbers). My favorite black coffee, much to my chagrin, is also out during the week because - shockingly - it's true what they say about it being a stomach bomb. But on Saturday mornings I like to really go crazy with myself, throw caution to the wind(!!!), and make a lil' something something for our enjoyment in front of about 100 seasons of Murder She Wrote (thanks to the blessed Netflix for providing J. with hours of that sassy evergreen sleuth, Angela Lansbury). This beauty (the scone, not Angela though she too is a beauty in her own way) is still paleo-friendly, definitely gluten-free, and remarkably low in added sugar. Unlike it's refined flour and sugar bomb counterparts, it's also incredibly filling. As with all of these paleo-ish treats, they're really best when enjoyed on the same day, as I've found that nut flour based baked goods taste fairly stale by the next day. Though in this case, that staleness turned this scone into a biscotti. A win-win and magical Sunday in my book.

Preheat the oven to 350 degrees. Line a baking sheet with parchment paper.

Mix all dry ingredients. Mix in solid coconut oil with your hands until mixture is crumbly. In a separate bowl, mix the remainder of the wet ingredients and then add to flour/oil crumbles. Add chocolate chips in and mix with hands. If batter seems to wet, add in a little more coconut flour (1tsp at a time...Coconut flour absorbs a ton of moisture and will dry out the finished product).

Shape batter into a ball and place on parchment paper. Form ball into a flattened disk about 1/2-1 inch thick. Cut into 8 triangles. Separate. Bake for approximately 20-22 minutes.

Sunday, February 21, 2016

And now for something completely different than what's been going on up in these parts over the past few months. The lovely members of our meditation group joined us at our house this morning to sit and I decided to mix it up and offer up something a little more universal than the nut butter paleo items I've been baking for J. and I. Something, instead, that warms the house and smells of the first hints of Spring. And also doesn't risk killing the tree nut allergic member. Who also happens to be allergic to berries. Thankfully he reminded me BEFORE biting into one of these. Smart guy.

These are super simple and incredibly allergen friendly. I used water, though you can use whatever milk (almond, soy, dairy, coconut, etc) you have on hand if you prefer. If you are not sugar sensitive, you can also make a glaze of lemon juice and sugar for the tops.

Mix first 5 ingredients. "Slice" in solid coconut oil so you end up with a crumbly mixture. In a separate bowl, make the flax egg and mix with water or milk. Add to dry mixture. Mix to combine. Add blueberries.

Dust a board with more oat flour and turn out the dough onto this. Form into a disk about 1 inch thick. Place on a baking sheet lined with parchment paper. Cut the disk into 6 triangles. Sprinkle with sugar. Bake for 25 minutes until golden brown.

Optional: Make a lemon glaze with the juice of one lemon mixed with a quarter cup of white cane sugar. After scones have baked, brush on glaze and let cool.

Thursday, February 18, 2016

Where did I leave us? Ah yes, after 25+ years of veganism, I made the switch to following a paleo-friendly, genotype based diet (more on this in an upcoming post) due to some pretty debilitating health conditions that I didn't know I had but definitely explained why I had been feeling so incredibly crappy for so many years despite eating a plant-based diet and getting plenty of exercise. And despite having a bunch of doctors who have been following me for a few years for lots of ridiculous sounding, alphabet soup conditions including MGUS or monoclonal gammopathy of undetermined significance (a "pre-malignant" condition often associated with a nasty cancer called multiple myeloma), POTS or postural orthostatic tachycardia (which makes for erratic and often very low blood pressure), and more recently small fiber neuropathy (which may or may not be related to the erratic blood pressure, but can cause tingling and numbness in my feet and hands).

Upon moving to Portland - a city in a State that recognizes the value of alternative medicine - I started seeing a naturopath as my primary care doctor, in addition to the hematologist who is an MD and follows my blood disorder. Naturopaths complete the same pre-med classes as MDs, attend naturopathic medical school for 4 years, are board certified and licensed. Only a few States have naturopathic medical schools (Oregon, Washington, Illinois, and Connecticut are a few) and recognize them as primary care physicians. Mine has been a godsend. Because even though I have been in the care of a few of some highly regarded medical doctors in NY, and even though there was a period in the past couple of years when I was losing weight for no explainable reason, and tests were run for unusual tumors, etc. it was the naturopath who discovered that I am pre-diabetic. Not yet diabetic but definitely on my way. As a lifelong sweets lover, this was pretty f-ing hard to hear. But here's the thing: diabetes and pre-diabetes are most often diagnosed if someone's fasting blood sugar is 100 or above. Mine has always been low. Most pre-diabetics are overweight. I am not. The only way to have known about pre-diabetes is to do a test called the A1C, a single-draw test that determines the average blood glucose over a period of three months. Mine was elevated in the pre-diabetes range. This in combination with severe anemia (my stored blood iron levels were 7, while normal is 50+), led to the decision to really, truly, not temporarily overhaul my lifestyle beginning with food.

I've said it before and I'll say it again: Nothing sucks more than having your body hand your ass to you. You can think you're doing "everything right" and following all of the most current wisdom and reading every magazine and book and making tons of green smoothies and splashing your face with coconut oil and trying to look "glowy" (if I could shoot a word, that would be it). Nature, my friends, doesn't give a crap what Gwyneth Paltrow says. Your own personal biology works a particular way based on thousands of years of evolution that allowed your ancestors to survive long enough to get you here. Listen to it for crap's sake. And don't do what works for everyone else. Do what works for YOU and YOUR body.

I learned that my body needs iron in the form of meat. There are two types of iron. Some is found in plants, some is found in meat. My body really and truly needs a combo of plant and animal based iron. When it doesn't get it, as I discovered the hard way, I become severely anemic, lose my hair, lose a ton of weight in the form of all of my muscle mass, lose my period, and look generally dried out and ghastly. Going for twice weekly iron infusions just so that I didn't feel like dropping dead wasn't fun. My iron levels are stable now and I make sure to follow a diet that supports that. Which brings me to: Sugar.

Full disclosure: Intellectually I understood that sugar acts as an inflammatory agent in our bodies and contributes to most of the major deadly diseases. I just don't think I ever thought that what I was eating was so bad. Following a vegan diet, I ate lots and lots of grains, sweet potatos, fruit, dried fruit, gluten-free flours and products (really super high in carbs usually) soy products, non-dairy ice cream, lots of dark chocolate. All of these are incredibly high in carbohydrates which equals sugar. We all need carbohydrates just not in the mass quantity that many vegan/vegetarian products and meal plans include. Correction. Some people are ok with lots of carbohydrates and very limited protein. Turns out my body is not one of those. So between the anemia and the pre-diabetes oh and the stomach problems, it was time for a total overhaul which FOR ME means very low carbohydrate (grain-free) and low to no added sugar, plenty of protein at every meal, and lots of healthy fat in the form of nuts, nut butters, seeds, and olive oil. Along with limiting black coffee to once or twice on the weekend (initially really hard and then awesome when I discovered that I could actually live heartburn-free), things are much, much better. Adding in other things I used to laugh at like meditation and yoga on the daily have also really helped. Perfect? No. But changes that seem to be working and I'm working with the changes.

Which brings me to my latest recipe. Like many folks I enjoy eggs for breakfast but seriously can't have them every day. Seriously. It gets to a point where I want to cry when I see eggs in a pan, in a frittata, scrambled, etc. I used to hate eggs. I got used to them. But they cause me much sadness when they're there every morning looking at me in a little sulfurous pile.

Both J. and I love a good morning baked good so I did a little research, tried out a couple of things, and came up with this super easy (if you have a microwave) delight. It tastes like it's full of flour and carbs, but doesn't have any grain in it at all and the tablespoon of molasses/maple syrup/honey can be replaced with a teaspoon of xylitol if you are avoiding sugar. Best eaten right after cooking so it doesn't dry out. I definitely don't recommend packing it up lest it become a leaden ball. Enjoy!

Optional: Feel free to sprinkle on a few more walnuts or dark chocolate chips. An extra drizzle of honey or maple syrup or chocolate syrup if that works for you. The recipe is not sweet at all and for some it might need a little boost. Go crazy with your bad self.

Mix all ingredients together in a medium/large mug making sure it doesn't splash up on to the sides of the mug. Place in the microwave and cook on high for between 2 1/2 and 4 1/2 minutes depending on your microwave. When ready, it should be steaming and separate easily from the mug on to a plate.